In:
Neonatology, S. Karger AG, Vol. 113, No. 3 ( 2018), p. 256-262
Abstract:
〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Many extremely preterm infants have low vitamin D concentrations at birth, but early childhood outcomes after vitamin D supplementation have not been reported. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To determine a dose-response relationship between increasing doses of enteral vitamin D in the first 28 days after birth and cognitive scores at 2 years of age. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In this phase II double-blind dose-response randomized trial, infants with gestational ages between 23 and 27 weeks were randomly assigned to receive placebo or a vitamin D dose of 200 or 800 IU/day from day 1 of enteral feeding to postnatal day 28. The primary outcome of this follow-up study was Bayley III cognitive score at 22-26 months of age. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Seventy of 80 survivors had a follow-up evaluation at 2 years of age (88%). There were no significant differences in cognitive scores between supplementation groups ( 〈 i 〉 p 〈 /i 〉 = 0.47). Cognitive scores did not differ between the higher vitamin D dose group and the placebo group (median difference favoring the 800 IU group: +5 points; 95% CI: −5 to 15; 〈 i 〉 p 〈 /i 〉 = 0.23). The linear trend between increasing doses of vitamin D and reduction of neurodevelopmental impairment (placebo group: 54%; 200 IU group: 43%; 800 IU group: 30%; 〈 i 〉 p 〈 /i 〉 = 0.08) or language impairment (placebo group: 64%; 200 IU group: 57%; 800 IU group: 45%; 〈 i 〉 p 〈 /i 〉 = 0.15) was not statistically significant. Respiratory outcomes at 2 years of age (need for supplemental oxygen or asthma medications) did not differ between groups. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In extremely preterm infants, early vitamin D supplementation did not significantly improve cognitive scores. Though underpowered for clinically meaningful differences in early childhood outcomes, this trial may help determine dosing for further investigation of vitamin D supplementation.
Type of Medium:
Online Resource
ISSN:
1661-7800
,
1661-7819
Language:
English
Publisher:
S. Karger AG
Publication Date:
2018
detail.hit.zdb_id:
2403535-X
SSG:
12
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